Adherence to Dietary Regimen and Recommended Physical Activity: A missing Link in the Management of Diabetes in Low-Resource Settings of Eastern Cape South Africa

Abstract

Background: Diabetes is a significant public health and socio-economic challenge. It is a complex health condition requiring medical therapy and modifications to dietary recommendations to attain treatment targets. Objective: To assess the level of adherence to recommended dietary regimen and physical activity and the factors responsible for non-adherence. Methods: This forms part of a larger multi-centre, two-arm, parallel, randomised-controlled trial designed to assess the effectiveness, feasibility and acceptability of mHealth as a tool to promote glycaemic control and adherence among low-income earning adults. Study was conducted among diabetic patients with uncontrolled glycaemic status in Eastern Cape Province of South Africa. A total of 216 participants were included in the study. A self-designed validated and reliable tool was used to collect information on dietary activity adherence as well as factors responsible for non-adherence. Descriptive statistics were carried out. Results: Over half of the patients have been taught about the recommended diet and only 10% follow the recommended diet always. The most cited reason for not adhering was perceived high cost of healthy diets. Only 13% adhere to recommended physical activity pattern and lack of time was the most cited reason. Even after a six months text messaging intervention, the condition persisted. Conclusion: There is a low rate of adherence to recommended diet and activity pattern among diabetic patients in this setting, partly due to their low socio-economic status. There is a need to organise interventions that prioritises the cultural beliefs and socio-economic status of patients to achieve the required modifications.